Ji Young Bang1, Robert Hawes2, Albert Bartolucci3, Shyam Varadarajulu2. 1. Division of Gastroenterology & Hepatology, Indiana University, Indianapolis, USA. 2. Center for Interventional Endoscopy, Florida Hospital, Orlando, USA. 3. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA.
Abstract
BACKGROUND AND AIM: Metal stents are being used more frequently for transmural endoscopic drainage of pancreatic fluid collections (PFC) despite lack of data. The present systematic review was conducted to compare the rates of treatment success, adverse events and recurrence between patients undergoing metal versus plastic stent placement for endoscopic transmural drainage of PFC. METHODS: MEDLINE and EMBASE were searched to identify all published manuscripts that evaluated metal stents for endoscopic transmural drainage of PFC. All published studies from the same period involving plastic stent placement for PFC drainage that included >50 patients were also identified. Main outcome measures were to compare the rates of treatment success, adverse events and recurrence between the metal and plastic stent cohorts. RESULTS: Seventeen studies (881 patients) met inclusion criteria. There was no difference in overall treatment success between patients treated with plastic and metal stents (81% [95% CI, 77-84%] vs 82% [95% CI, 74-88%]) for both pseudocysts (85% [95% CI, 81-89%] vs 83% [95% CI, 74-89%]) and walled-off necrosis (70% [95% CI, 62-76%] vs 78% [95% CI, 50-93%]). Also, there was no difference in the rates of adverse events (16% [95% CI, 14-39%] vs 23% [95% CI, 16-33%]) or recurrence (10% [95% CI, 8-13%] vs 9% [95% CI, 4-19%]) between plastic and metal stents. CONCLUSIONS: Current evidence does not support routine placement of metal stents for transmural drainage of PFC. Randomized trials are needed to justify the use of metal stents for PFC drainage.
BACKGROUND AND AIM: Metal stents are being used more frequently for transmural endoscopic drainage of pancreatic fluid collections (PFC) despite lack of data. The present systematic review was conducted to compare the rates of treatment success, adverse events and recurrence between patients undergoing metal versus plastic stent placement for endoscopic transmural drainage of PFC. METHODS: MEDLINE and EMBASE were searched to identify all published manuscripts that evaluated metal stents for endoscopic transmural drainage of PFC. All published studies from the same period involving plastic stent placement for PFC drainage that included >50 patients were also identified. Main outcome measures were to compare the rates of treatment success, adverse events and recurrence between the metal and plastic stent cohorts. RESULTS: Seventeen studies (881 patients) met inclusion criteria. There was no difference in overall treatment success between patients treated with plastic and metal stents (81% [95% CI, 77-84%] vs 82% [95% CI, 74-88%]) for both pseudocysts (85% [95% CI, 81-89%] vs 83% [95% CI, 74-89%]) and walled-off necrosis (70% [95% CI, 62-76%] vs 78% [95% CI, 50-93%]). Also, there was no difference in the rates of adverse events (16% [95% CI, 14-39%] vs 23% [95% CI, 16-33%]) or recurrence (10% [95% CI, 8-13%] vs 9% [95% CI, 4-19%]) between plastic and metal stents. CONCLUSIONS: Current evidence does not support routine placement of metal stents for transmural drainage of PFC. Randomized trials are needed to justify the use of metal stents for PFC drainage.
Authors: Abed Al Lehibi; Abdullah Al Jabri; Shahem Abbarh; Areej Al Balkhi; Nawwaf Al Otaibi; Thamer Almasoudi; Abdullah Al Mtawa; Adel AlGhamdi; Ahmad Al Eid; Ahmed Al Ghamdi; Abdullah Al Khathlan; Adel Qutub; Khalid Al Sayari; Shameem Ahmad Journal: Saudi J Gastroenterol Date: 2021 Mar-Apr Impact factor: 2.485
Authors: Maria Chiara Petrone; Livia Archibugi; Edoardo Forti; Rita Conigliaro; Roberto Di Mitri; Ilaria Tarantino; Carlo Fabbri; Alberto Larghi; Sabrina Gloria Giulia Testoni; Massimiliano Mutignani; Paolo Giorgio Arcidiacono Journal: United European Gastroenterol J Date: 2018-06-17 Impact factor: 4.623